Actuator pin fracture in magnetically controlled growing rods: two cases

Jones, Conor S; Stokes, Oliver M.; Patel, Sonam; Clarke, Andrew; Hutton, Michael

doi:10.1016/j.spinee.2015.12.020

Cited by 38 publications

(22 citation statements)

References 19 publications

(33 reference statements)

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“…Our primary outcome measure was evidence of pin fracture on plain radiographs taken of the explanted device [16], Fig. 2b, c.…”

Section: Plain Radiographsmentioning

confidence: 99%

“…Recently, one paper with two case reports was published suggesting that the internal mechanism of a certain design of spinal rod (MAGnetic Expansion Control, Nuvasive Inc.) can fracture, resulting in the failure of the lengthening mechanism [16]. This is further supported by a 4 year follow-up study that included one case of a fractured pin within the rod [17].…”

Section: Introductionmentioning

confidence: 96%

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Analysing a mechanism of failure in retrieved magnetically controlled spinal rods

et al. 2017

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Purpose We aim to describe a mechanism of failure in magnetically controlled growth rods which are used for the correction of the early onset scoliosis. Methods This retrieval study involved nine magnetically controlled growth rods, of a single design, revised from five patients for metal staining, progression of scoliosis, swelling, fractured actuator pin, and final fusion. All the retrieved rods were radiographed and assessed macroscopically and microscopically for material loss. Two implants were further analysed using micro-CT scanning and then sectioned to allow examination of the internal mechanism. No funding was obtained to analyse these implants. There were no potential conflicts interests. Results Plain radiographs revealed that three out of nine retrieved rods had a fractured pin. All had evidence of surface degradation on the extendable telescopic rod. There was considerable corrosion along the internal mechanism. Conclusions We found that a third of the retrieved magnetically controlled growth rods had failed due to pin fracture secondary to corrosion of the internal mechanism. We recommend that surgeons consider that any inability of magnetically controlled growth rods to distract may be due to corrosive debris building up inside the mechanism, thereby preventing normal function.

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“…Our primary outcome measure was evidence of pin fracture on plain radiographs taken of the explanted device [16], Fig. 2b, c.…”

Section: Plain Radiographsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Analysing a mechanism of failure in retrieved magnetically controlled spinal rods

et al. 2017

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“…Our follow-up period ranged from 24 to 46 months. Reported complications of MCGR are rod fracture, pin fracture of the actuator, proximal junctional kyphosis, and superficial and deep spinal infections [3,8,10,24]. We observed no complications in our patients, even though we followed up our patients for at least 24 months.…”

Section: Discussionmentioning

confidence: 53%

Magnetically Controlled Growing Rod in Early-Onset Scoliosis: A Minimum of 2-Year Follow-Up

et al. 2016

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Purpose: The magnetically controlled growing rod technique decreases complications, costs, and loss of functionality by avoiding successive surgical corrections every 6 months in patients with early-onset scoliosis. However, only a few studies have presented clinical experience with the magnetically controlled growing rod. In this study we aimed to present our single-center experience in patients with early-onset scoliosis who underwent the magnetically controlled growing rod technique and follow-up for at least 2 years. Materials and Methods: We made an observational study by evaluating patients with early-onset scoliosis who underwent the magnetically controlled growing rod technique between February 2012 and December 2013. Demographic and clinical data were obtained from the patients charts. We included patients who were followed up for at least 2 years. Radiological data were obtained from plain anterior-posterior and lateral scoliosis X-rays. Results: Eight patients with early-onset scoliosis who underwent surgery using the magnetic system were treated with dual rods. None of the spines were fused to the sacrum. We observed no intra- and/or postsurgical complications. The average number of external rod lengthenings was 7.6. The average amount of lengthening was 30.6 mm on the right side and 27.8 mm on the left side by the time of last clinical follow-up. The average coronal and sagittal Cobb values at the final clinical evaluation were 10.5° (thoracic coronal), 13.75° (lumbar coronal), 6.25° (lumbosacral coronal), 24.5° (thoracic sagittal), and 40° (lumbar sagittal), respectively. Conclusions: The magnetically controlled growing rod is beneficial in early-onset scoliosis, since it enables spinal growth and decreases additional surgeries, complications, and costs. Even though we had a small sample size, our follow-up period was enough to declare long-term outcomes of our patients. Multicenter and large sample-sized studies are needed to make more conclusive statements regarding this promising scoliosis treatment approach.

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“…The results of the study for both groups including p-values are presented in Table 3. Overall patient-parent satisfaction with the MCGR treatment was rated to a median 10 (6)(7)(8)(9)(10) in the MCGR group vs. 9(2-10) in the fusion group [0 very dissatisfi ed, 10 very satisfi ed].…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, MCGR treatment is on the rise worldwide [4][5][6][7]. Despite the fi ndings of recent reports on MCGR-actuator failures [8] and complications similar to those affi liated with conventional growing rods [3,9], MCGR treatment is still considered an evolution in distraction-based growth instrumentation in the surgical management of EOS.…”

Section: Introductionmentioning

confidence: 99%

High global satisfaction in magnetically controlled elongations in 29 early-onset scoliosis patients versus primary spinal fusion in 20 adolescent idiopathic scoliosis patients

Skov¹,

Bünger²,

Rölfing³

et al. 2019

Open J Orthop Rheumatol

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Background and purpose: Early-Onset Scoliosis (EOS) treatment aim to improve natural history and the child's quality of life. Magnetically Controlled Growing-Rods (MCGRs) represented a major evolution in distraction-based management of EOS by eliminating the surgical elongations. The technique can be used until cessation of growth and consequently it overlaps with primary Permanent Deformity Surgery (PDS). Patient reported outcomes of growth instrumentation compared to PDS is an interesting but uninvestigated subject.Our aim was to investigate the psychological burden, physical burden and global satisfaction in MCGR lengthening procedures in EOS patients and their parents, compared to PDS in adolescent idiopathic scoliosis patients. Patients and methods:A single-center cross-sectional cohort study: 29 MCGR-treated EOS patients, mean age 11(range, 6-14) years, compared to a PDS control group of 20 AIS patients age 16(12-20) years. Follow up in the MCGR group was 25(SD 14) months and 19(SD 12) months in the PDS group. The parents responded to a 9-item Satisfaction Questionnaire with a 0-10 Likert scale [0 none, 10 maximum]. Results:The median (range) physical strain was 0(0-7) for MCGR vs. 7(5-9) in PDS, the psychological strain was 0(0-7) vs. 7(0-10), the procedure related back pain was 0(0-5) vs. 8(0-10), the pain intensity between distractions/follow-up 0(0-8) vs. 2(0-8), the parental concern was 0(0-7) vs. 9(2-10). Overall satisfaction of the treatment concept was 10(6-10) vs. 9(2-10). Interpretation:Overall satisfaction was uniformly high in both groups. Both the physical and psychological strain and pain in conjunction with MCGR lengthening procedures were low in comparison with primary deformity surgery. Level of evidence:Level IV, cross-sectional cohort study. ORCiD: https://orcid.org/0000-0002-2089-7113 https://www.peertechz.com 006 https://www.peertechz.com/journals/open-journal-of-orthopedics-and-rheumatology Citation: Skov ST, Bünger C, Rölfing JD, Hansen ES, Høy K, et al. (2019) High global satisfaction in magnetically controlled elongations in 29 early-onset scoliosis patients versus primary spinal fusion in 20 adolescent idiopathic scoliosis patients. Open J Orthop Rheumatol 4(1): 005-009.

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Actuator pin fracture in magnetically controlled growing rods: two cases

Cited by 38 publications

References 19 publications

Analysing a mechanism of failure in retrieved magnetically controlled spinal rods

Analysing a mechanism of failure in retrieved magnetically controlled spinal rods

Magnetically Controlled Growing Rod in Early-Onset Scoliosis: A Minimum of 2-Year Follow-Up

High global satisfaction in magnetically controlled elongations in 29 early-onset scoliosis patients versus primary spinal fusion in 20 adolescent idiopathic scoliosis patients

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